Impact of antiretroviral treatment on AIDS dementia: a longitudinal prospective event-related potential study.
We investigated the impact of antiretroviral treatment on event-related potentials (ERP) as a possible marker of AIDS dementia. A total of 154 HIV-infected patients without central nervous system (CNS) neoplasm or opportunistic infection were examined and randomized to receive either zidovudine 500 mg/day or no antiretroviral treatment. The participants were prospectively examined by visually evoked ERP in a longitudinal design. Latencies and amplitudes of ERP were evaluated at the beginning of the study, after 1 year, and after 2 years. After 1 year, 98 patients could be analyzed, 47 of whom were taking zidovudine. In the treatment group, P3 latency was 419 +/- 55 msec at baseline and 424 +/- 52 msec at follow-up (not significant). In the patients without treatment, P3 latency was 437 +/- 42 msec at baseline and 462 +/- 53 msec at follow-up (p < .0001, Wilcoxon test). A significant inverse correlation existed between P3 latency and CD4 cell count in both groups. The increase of P3 latency in untreated patients and a stable P3 latency in treated patients could be confirmed in a subgroup analysis of 21 patients with a follow-up of three examinations in a 2-year period. Our data suggest that zidovudine has a positive impact on AIDS dementia as measured by ERP. This finding was observed in patients in different stages of HIV infection, thus suggesting that zidovudine is indicated in all stages of HIV infection to treat encephalopathy.
Evers
S
S
Department of Neurology, University of Münster, Germany. everss@uni_muenster.de
Grotemeyer
K H
KH
Reichelt
D
D
Lüttmann
S
S
Husstedt
I W
IW
D015526:AIDS Dementia Complex / Q000628:therapy*; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D003071:Cognition / Q000187:drug effects*; D005071:Evoked Potentials; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D015215:Zidovudine / Q000627:therapeutic use*
D019380:Anti-HIV Agents; D015215:Zidovudine